Newborn Circumcision, Sydney

Circumcision is a surgical procedure to remove the foreskin.

Parents request their newborn sons to be circumcised for religious, cultural and other personal reasons.

In a small amount of newborn boys circumcision may be medically indicated or advised. This can be discussed during a consultation with one of our surgeons: Dr Anthony Dilley or Dr Carolyn Russell.

Anaesthesia

Circumcision can be performed in the newborn period (up to 12 weeks of age) with an ultrasound guided local anaesthetic injection – this ensures the penis is numb during the procedure.

Boys over 12 weeks of age require a general anaesthetic for their circumcision, this is done after six months of age unless medically indicated.

A consultation is required with one of our surgeons, and the hospital will be organised during the consultation.

Risks

The risks and benefits of circumcision are listed below. If you require more in depth information, a consultation can be arranged prior to your decision to proceed with the circumcision.

• Bleeding
• Infection
• Adhesions/scarring
• Meatal stenosis
• Excess skin remaining

The Debated Benefits

Health advantages exist for newborns who are circumcised – a reduced incidence of urinary tract infections, sexually transmitted diseases, prostate cancer, penile cancer and cervical cancer in sexual partners, and a greatly reduced risk for infection and trauma to the foreskin. Statistics show that a benefit is definitely present – parents will interpret those figures differently according to how they see the benefits stack up against the downsides of circumcision.

How might you argue about the benefits listed above?

The risk of a urinary tract infection in a newborn boy is around 1% (and lifetime risk around 14%) – which is pretty low, Circumcision reduces this risk at least tenfold, to around one in a thousand or less. This is an advantage to boys already getting urinary tract infections or who are at risk of significant kidney damage (vesico-ureteric reflux), but may not be a significant advantage to an otherwise healthy boy.

Recent evidence suggests that if a man has unprotected sex with a partner who is herpes or HIV positive, being circumcised reduces the risk of contracting the virus from that single episode of contact by as much as 50%. This also holds true for many other sexually transmitted diseases and would be significant if it was only a single episode of exposure being considered – frequent unprotected sex with multiple partners erodes this benefit quickly.

The lifetime risk of cancer of the penis overall is about one in 500, as compared to one in 50,000 or more for circumcised males. There is also less risk of cancer of the cervix in female partners of circumcised men, though this fact may now be less relevant with HPV vaccines. Cancer of the prostate seems to be twice more common in uncircumcised men and this observation has been shown in some cases to be related to viral infections.

You may argue that infection of the foreskin should be treated the same as an infected finger or breast – antibiotics first rather than the removal of the infected part. Some parents and children become quite distressed at a single episode of foreskin infection and opt for immediate circumcision to prevent another episode. Some families only opt for circumcision after four or five episodes. There is no right answer, though most surgeons will offer circumcision as an option after two or three episodes of infection.

If you have concerns about adhesions please contact the rooms for review by Dr Dilley or Dr Russell.

Make an appointment to see Dr Carolyn Russell at Sydney Children’s Surgery at her clinic in Gymea or Randwick, Liverpoolor Oran Park.

Please call 02-9540 4409 to speak with our helpful reception staff, or complete our online contact form.